Case 2-CPP B Shanthi

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280
CLIENT CODE : C000104546
CLIENT'S NAME AND ADDRESS :

CONNECT AND HEAL PRIMARY CARE PVT LTD - NORTH SRL Ltd
401, MULTILINK HOUSE FLOOR 4, 3RD ROAD UNI CONTINENTAL, LEGEND CRYSTAL,SHOP NO-6,GROUND & 1ST FLOOR,PLOT NO-1-7-
HOTEL KHAR WEST, 79/A B:,PRENDERGHAST ROAD
MUMBAI 400052 SECUNDERABAD, 500003
MAHARASHTRA INDIA TELANGANA, INDIA
8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
Email : [email protected]
PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217
ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Female
DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00
REFERRING DOCTOR : SELF CLIENT PATIENT ID :
Test Report Status Final Results Biological Reference Interval Units
BLOOD COUNTS,EDTA WHOLE BLOOD

HEMOGLOBIN 14.2 13.0 - 17.0 g/dL
RED BLOOD CELL COUNT 4.30 4.5 - 5.5 mil/µL
WHITE BLOOD CELL COUNT 8.20 4.0 - 10.0 thou/µL
PLATELET COUNT 256 150 - 410 thou/µL
RBC AND PLATELET INDICES
HEMATOCRIT 41.7 40 - 50 %
MEAN CORPUSCULAR VOL 89.0 83 - 101 fL
MEAN CORPUSCULAR HGB. 28.4 27.0 - 32.0 pg
MEAN CORPUSCULAR HEMOGLOBIN 31.0 31.5 - 34.5 g/dL
CONCENTRATION
RED CELL DISTRIBUTION WIDTH 12.7 11.6 - 14.0 %
MEAN PLATELET VOLUME 8.0 6.8 - 10.9 fL
WBC DIFFERENTIAL COUNT - NLR
SEGMENTED NEUTROPHILS 57 40 - 80 %
ABSOLUTE NEUTROPHIL COUNT 4.88 2.0 - 7.0 thou/µL
LYMPHOCYTES 35 20 - 40 %
ABSOLUTE LYMPHOCYTE COUNT 1.80 1.0 - 3.0 thou/µL
NEUTROPHIL LYMPHOCYTE RATIO (NLR) 1.3
EOSINOPHILS 1 1-6 %
ABSOLUTE EOSINOPHIL COUNT 0.07 0.02 - 0.50 thou/µL
MONOCYTES 4 2 - 10 %
ABSOLUTE MONOCYTE COUNT 0.65 0.2 - 1.0 thou/µL
BASOPHILS 1 0-2 %
ABSOLUTE BASOPHIL COUNT 0.09 0.02 - 0.10 thou/µL
DIFFERENTIAL COUNT PERFORMED ON: EDTA SMEAR
PERIPHERAL SMEAR EXAM, EDTA WHOLE BLOOD
RBC NORMOCYTIC NORMOCHROMIC.
WBC WITHIN NORMAL LIMITS.
PLATELETS ADEQUATE ON SMEAR.
Scan to View Details Scan to View Report

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280

8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male
IMPRESSION NORMAL PERIPHERAL SMEAR.

ERYTHRO SEDIMENTATION RATE, BLOOD
SEDIMENTATION RATE (ESR) 11 0 - 14 mm at 1 hr
CORONARY RISK PROFILE (LIPID PROFILE), SERUM
CHOLESTEROL 178 < 200 Desirable mg/dL

200 - 239 Borderline High
>/= 240 High
TRIGLYCERIDES 143 < 150 Normal mg/dL
200 - 499 High
>/=500 Very High
HDL CHOLESTEROL 70 < 40 Low mg/dL
>/=60 High
DIRECT LDL CHOLESTEROL 110 < 100 Optimal mg/dL
100 - 129 Near or above optimal
160 - 189 High
>/= 190 Very High
NON HDL CHOLESTEROL 120 Desirable: Less than 130 mg/dL
Above Desirable: 130 - 159
Borderline High: 160 - 189
High: 190 - 219
Very high: > or = 220
CHOL/HDL RATIO 3.5 3.3 - 4.4 Low Risk
4.5 - 7.0 Average Risk
7.1 - 11.0 Moderate Risk
> 11.0 High Risk
LDL/HDL RATIO 2.4 0.5 - 3.0 Desirable/Low Risk
3.1 - 6.0 Borderline/Moderate Risk
>6.0 High Risk
VERY LOW DENSITY LIPOPROTEIN 27.2 </= 30.0 mg/dL
LIVER FUNCTION PROFILE, SERUM
BILIRUBIN, TOTAL 0.48 0.2 - 1.0 mg/dL
BILIRUBIN, DIRECT 0.07 0.0 - 0.2 mg/dL
BILIRUBIN, INDIRECT 0.49 0.1 - 1.0 mg/dL
TOTAL PROTEIN 7.4 6.4 - 8.2 g/dL
ALBUMIN 4.0 3.4 - 5.0 g/dL
GLOBULIN 3.3 2.0 - 4.1 g/dL
ALBUMIN/GLOBULIN RATIO 1.3 1.0 - 2.1 RATIO
ASPARTATE AMINOTRANSFERASE (AST/SGOT) 28 15 - 37 U/L

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280

8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
ALANINE AMINOTRANSFERASE (ALT/SGPT) 40 < 45.0 U/L

ALKALINE PHOSPHATASE 71 30 - 120 U/L
GAMMA GLUTAMYL TRANSFERASE (GGT) 49 15 - 85 U/L
LACTATE DEHYDROGENASE 156 100 - 190 U/L
SERUM BLOOD UREA NITROGEN
BLOOD UREA NITROGEN 10 6 - 20 mg/dL
URIC ACID, SERUM
URIC ACID 5.4 3.5 - 7.2 mg/dL
GLUCOSE, FASTING, PLASMA
GLUCOSE, FASTING, PLASMA 90 74 - 99 mg/dL
CREATININE, SERUM
CREATININE 0.91 L 0.90 - 1.30 mg/dL
ECG
ECG TEST NOT PERFORMED
XRAY (ONE FILM USED)
XRAY ONE NO ABNORMALITIES DETECTED
MEDICAL HISTORY
RELEVANT PRESENT HISTORY NOT SIGNIFICANT
RELEVANT PAST HISTORY NOT SIGNIFICANT
RELEVANT PERSONAL HISTORY NOT SIGNIFICANT
RELEVANT FAMILY HISTORY NOT SIGNIFICANT
OCCUPATIONAL HISTORY NOT SIGNIFICANT
HISTORY OF MEDICATIONS NOT SIGNIFICANT
ANTHROPOMETRIC DATA & BMI
HEIGHT IN METERS 1.57 mts
WEIGHT IN KGS. 93 Kgs
BMI 38.7 BMI & Weight Status as follows: kg/sqmts
Below 18.5: Underweight
18.5 - 24.9: Normal
25.0 - 29.9: Overweight
30.0 and Above: Obese
GENERAL EXAMINATION
MENTAL / EMOTIONAL STATE NORMAL
PHYSICAL ATTITUDE NORMAL

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280

8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
GENERAL APPEARANCE / NUTRITIONAL STATUS HEALTHY

BUILT / SKELETAL FRAMEWORK AVERAGE
FACIAL APPEARANCE NORMAL
SKIN NORMAL
UPPER LIMB NORMAL
LOWER LIMB NORMAL
NECK NORMAL
NECK LYMPHATICS / SALIVARY GLANDS NOT ENLARGED OR TENDER
THYROID GLAND NOT ENLARGED
CAROTID PULSATION NORMAL
BREAST (FOR FEMALES) NORMAL
TEMPERATURE NORMAL
PULSE 80/REGULAR, ALL PERIPHERAL PULSES WELL FELT, NO CAROTID BRUIT
RESPIRATORY RATE NORMAL
CARDIOVASCULAR SYSTEM
BP 120/80 MM HG mm/Hg
(SITTING)
PERICARDIUM NORMAL
APEX BEAT NORMAL
HEART SOUNDS NORMAL
MURMURS ABSENT
RESPIRATORY SYSTEM
SIZE AND SHAPE OF CHEST NORMAL
MOVEMENTS OF CHEST SYMMETRICAL
BREATH SOUNDS INTENSITY NORMAL
BREATH SOUNDS QUALITY VESICULAR (NORMAL)
ADDED SOUNDS ABSENT
PER ABDOMEN
APPEARANCE NORMAL
VENOUS PROMINENCE ABSENT
LIVER NOT PALPABLE
SPLEEN NOT PALPABLE
HERNIA ABSENT

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280

8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
CENTRAL NERVOUS SYSTEM

HIGHER FUNCTIONS NORMAL
CRANIAL NERVES NORMAL
CEREBELLAR FUNCTIONS NORMAL
SENSORY SYSTEM NORMAL
MOTOR SYSTEM NORMAL
REFLEXES NORMAL
MUSCULOSKELETAL SYSTEM
SPINE NORMAL
JOINTS NORMAL
BASIC EYE EXAMINATION
CONJUNCTIVA NORMAL
EYELIDS NORMAL
EYE MOVEMENTS NORMAL
CORNEA NORMAL
DISTANT VISION RIGHT EYE WITHOUT GLASSES 6/12
DISTANT VISION LEFT EYE WITHOUT GLASSES 6/12
NEAR VISION RIGHT EYE WITHOUT GLASSES N-8
NEAR VISION LEFT EYE WITHOUT GLASSES N-8
COLOUR VISION NORMAL
BASIC ENT EXAMINATION
EXTERNAL EAR CANAL NORMAL
TYMPANIC MEMBRANE NORMAL
NOSE NO ABNORMALITY DETECTED
SINUSES CLEAR
THROAT NO ABNORMALITY DETECTED
TONSILS NOT ENLARGED
BASIC DENTAL EXAMINATION
TEETH NORMAL
GUMS HEALTHY
SUMMARY
RELEVANT HISTORY NOT SIGNIFICANT
RELEVANT GP EXAMINATION FINDINGS NOT SIGNIFICANT

DIAGNOSTIC REPORT
Patient Ref. No. 777000001716280

8291272004 8291272004 Tel : 9111591115, Fax :
CIN - U74899PB1995PLC045956
RELEVANT LAB INVESTIGATIONS FBS-105,SGPT-52, ESR-22.

RELEVANT NON PATHOLOGY DIAGNOSTICS OBESE.
REMARKS / RECOMMENDATIONS REPEAT FBS.
ADVICE TO FOLLOW UP WITH PHYSICIAN FOR RAISED ESR.
ADVICE TO FOLLOW UP WITH PHYSICIAN FOR RAISED LIVER ENZYMES.
NEEDS SIGNIFICANTS WEIGHT REDUCTION, PHYSICAL EXCERCISES
ARE SUGGEST. AVOID OILY AND JUNK FOODS. HAVE DIETICIAN
OPINION FOR WEIGHT REDUCTION.
FITNESS STATUS
FITNESS STATUS FIT (WITH MEDICAL ADVICE) (AS PER REQUESTED PANEL OF TESTS)
Interpretation(s)
BLOOD COUNTS,EDTA WHOLE BLOOD-The cell morphology is well preserved for 24hrs. However after 24-48 hrs a progressive increase in MCV and HCT is observed leading
to a decrease in MCHC. A direct smear is recommended for an accurate differential count and for examination of RBC morphology.
WBC DIFFERENTIAL COUNT - NLR-
The optimal threshold of 3.3 for NLR showed a prognostic possibility of clinical symptoms to change from mild to severe in COVID positive patients. When age = 49.5 years
old and NLR = 3.3, 46.1% COVID-19 patients with mild disease might become severe. By contrast, when age < 49.5 years old and NLR < 3.3, COVID-19 patients tend to
show mild disease.
(Reference to - The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients A.-P. Yang, et al. International Immunopharmacology 84 (2020) 106504
This ratio element is a calculated parameter and out of NABL scope.
ERYTHRO SEDIMENTATION RATE, BLOOD-Erythrocyte sedimentation rate (ESR) is a non - specific phenomena and is clinically useful in the diagnosis and monitoring of
disorders associated with an increased production of acute phase reactants. The ESR is increased in pregnancy from about the 3rd month and returns to normal by the 4th
week post partum. ESR is influenced by age, sex, menstrual cycle and drugs (eg. corticosteroids, contraceptives). It is especially low (0 -1mm) in polycythaemia,
hypofibrinogenemia or congestive cardiac failure and when there are abnormalities of the red cells such as poikilocytosis, spherocytosis or sickle cells.
Reference :
1. Nathan and Oski’s Haematology of Infancy and Childhood, 5th edition
2. Paediatric reference intervals. AACC Press, 7th edition. Edited by S. Soldin
3. The reference for the adult reference range is “Practical Haematology by Dacie and Lewis, 10th Edition”
CORONARY RISK PROFILE (LIPID PROFILE), SERUM-Serum cholesterol is a blood test that can provide valuable information for the risk of coronary artery disease This test
can help determine your risk of the build up of plaques in your arteries that can lead to narrowed or blocked arteries throughout your body (atherosclerosis). High
cholesterol levels usually don''''''''''''''''t cause any signs or symptoms, so a cholesterol test is an important tool. High cholesterol levels often are a significant risk factor for
heart disease and important for diagnosis of hyperlipoproteinemia, atherosclerosis, hepatic and thyroid diseases.
Serum Triglyceride are a type of fat in the blood. When you eat, your body converts any calories it doesn''''''''''''''''t need into triglycerides, which are stored in fat cells. High
triglyceride levels are associated with several factors, including being overweight, eating too many sweets or drinking too much alcohol, smoking, being sedentary, or having
diabetes with elevated blood sugar levels. Analysis has proven useful in the diagnosis and treatment of patients with diabetes mellitus, nephrosis, liver obstruction, other
diseases involving lipid metabolism, and various endocrine disorders. In conjunction with high density lipoprotein and total serum cholesterol, a triglyceride determination
provides valuable information for the assessment of coronary heart disease risk.It is done in fasting state.
High-density lipoprotein (HDL) cholesterol. This is sometimes called the ""good"" cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and
blood flowing more freely.HDL cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption
and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.
SERUM LDL The small dense LDL test can be used to determine cardiovascular risk in individuals with metabolic syndrome or established/progressing coronary artery
disease, individuals with triglyceride levels between 70 and 140 mg/dL, as well as individuals with a diet high in trans-fat or carbohydrates. Elevated sdLDL levels are
associated with metabolic syndrome and an ‘atherogenic lipoprotein profile’, and are a strong, independent predictor of cardiovascular disease.
Elevated levels of LDL arise from multiple sources. A major factor is sedentary lifestyle with a diet high in saturated fat. Insulin-resistance and pre-diabetes have also been
implicated, as has genetic predisposition. Measurement of sdLDL allows the clinician to get a more comprehensive picture of lipid risk factors and tailor treatment
accordingly. Reducing LDL levels will reduce the risk of CVD and MI.
Recommendations:
Results of Lipids should always be interpreted in conjunction with the patient’s medical history, clinical presentation and other findings.

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DIAGNOSTIC REPORT

Patient Ref. No. 777000001716280

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Female

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

BLOOD COUNTS,EDTA WHOLE BLOOD

WBC WITHIN NORMAL LIMITS.

PLATELETS ADEQUATE ON SMEAR.

Scan to View Details Scan to View Report

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

IMPRESSION NORMAL PERIPHERAL SMEAR.

CHOLESTEROL 178 < 200 Desirable mg/dL

Scan to View Details Scan to View Report

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

ALANINE AMINOTRANSFERASE (ALT/SGPT) 40 < 45.0 U/L

Scan to View Details Scan to View Report

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

GENERAL APPEARANCE / NUTRITIONAL STATUS HEALTHY

Scan to View Details Scan to View Report

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

CENTRAL NERVOUS SYSTEM

Scan to View Details Scan to View Report

CLIENT CODE : C000104546

CLIENT'S NAME AND ADDRESS :

PATIENT NAME : B SHANTHI PATIENT ID : NANDM01069217

ACCESSION NO : 0042UL013478 AGE : 38 Years SEX : Male

DRAWN : RECEIVED : 13/01/2023 10:00 REPORTED : 13/01/2023 11:00

REFERRING DOCTOR : SELF CLIENT PATIENT ID :

Test Report Status Final Results Biological Reference Interval Units

RELEVANT LAB INVESTIGATIONS FBS-105,SGPT-52, ESR-22.